Radiographic Findings

A chest x-ray shows multiple, nodular, ill-defined, hazy opacities, most prominent at the lung periphery and in the mid and lower lung zones.

 

A CT scan was taken at the same time. Note the predominant peripheral location of the rounded densities, which are ground-glass and consolidative in nature. The densities contain numerous, tiny, bubble-like lucencies.

Toward the base, the opacities become larger and more confluent but maintain their peripheral predominance.

What is the differential diagnosis for multiple peripheral densities? Answer 1

Bubble-like lucencies can be seen on HRCT in what type of disease processes? Answer 2

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Answer 1: The differential diagnosis for multiple peripheral densities includes pulmonary infarcts, cryptogenic organizing pneumonia (BOOP), chronic eosinophilic pneumonia, and bronchioloalveolar carcinoma.

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Answer 2: Bubble-like lucencies may be seen in adenocarcinoma, bronchioloalveolar carcinoma, and pulmonary infarcts. In adenocarcinoma and bronchioloalveolar carcinoma, the lucencies represent patent small airways. In pulmonary infarction, the lucencies represent aerated acini or lobules within the hemorrhagic lung.

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